Individual provider Active NPI

Sondra Akins Siatkowski, AGNP-C

  • Adult Health Nurse Practitioner
  • Mentor, OH
National Provider Identifier
1174287148
Registry record updated Nov 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
APRN.CNP.0029339 Issued in OH
Practice address
9485 Mentor Ave Ste 210
Mentor, OH 44060-8723
Phone
(440) 255-5571
Fax
(440) 255-5548
NPI assigned
Oct 26, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 29, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X APRN.CNP.0029339 OH Primary

Addresses

Primary practice location

9485 Mentor Ave Ste 210
Mentor, OH 44060-8723

Mailing address

7469 Lake Shore Blvd
Mentor, OH 44060-3557
Phone (440) 339-3204

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220112001082 OH Practitioner - Nurse Practitioner 7618369281 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lake Hospital System, Inc.Group PAC ID 6002713922, 92 clinicians

Practice addresses (Care Compare)

9485 Mentor Ave
Suite 210
Mentor, OH 44060-8723
Phone (440) 205-5835

Hospital & facility affiliations

  • Residence Home Care LLC Home health agency, North Olmsted, OH, CCN 369153
  • Caretenders Home health agency, Madison, OH, CCN 367548
  • Always Best Care Cleveland South Home health agency, Middleburg Heights, OH, CCN 368392
  • Hospice of the Western Reserve, Inc Hospice, Cleveland, OH, CCN 361503
  • Hospice of the Western Reserve at University Hosp Hospice, Cleveland, OH, CCN 361678
  • Suncrest Hospice Cleveland LLC Hospice, Independence, OH, CCN 361726

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Lake Hospital System, Inc CurrentSince Dec 13, 2021 Accepting new patients
Lake Hospital System Inc CurrentSince Dec 13, 2021 Accepting new patients

Locations

7590 Auburn Rd
Ste 14
Concord Township, OH 44077
Phone (440) 354-1899

9485 Mentor Ave
Ste 210
Mentor, OH 44060
Phone (440) 205-5835

10780 Kinsman Rd
Newbury, OH 44065
Phone (440) 564-5656

Interoperability endpoints

  • Direct secure messaging: ssiatkowski28040@ehrdirect.uhhospitals.org

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1635206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638144000000",
    "number": "1174287148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7469 LAKE SHORE BLVD",
            "city": "MENTOR",
            "state": "OH",
            "postal_code": "440603557",
            "telephone_number": "440-339-3204"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9485 MENTOR AVE STE 210",
            "city": "MENTOR",
            "state": "OH",
            "postal_code": "440608723",
            "telephone_number": "440-255-5571",
            "fax_number": "440-255-5548"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIATKOWSKI",
        "first_name": "SONDRA",
        "middle_name": "AKINS",
        "name_prefix": "Mrs.",
        "credential": "AGNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-10-26",
        "last_updated": "2021-11-29",
        "certification_date": "2021-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "OH",
            "license": "APRN.CNP.0029339",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mentor, OH

Sources for this page

Verify at the official NPI Registry.